Overview.
Abdominal aortic thrombosis syndrome, also known as aortic bifurcation occlusion syndrome or terminal aortic thrombosis syndrome, progressive terminal aortic partial thrombosis syndrome, terminal aortoiliac artery atresia syndrome, chronic abdominal aortoiliac artery obstruction, and isolated abdominal aortoiliac arteriopathy, is also known as Leriche syndrome.In 1940, Leriche described the lower limb ischemia syndrome caused by sclerotic obstruction at the aortic bifurcation. In 1940, Leriche described a lower limb ischemic syndrome caused by sclerotic obstruction of the aortic bifurcation.
Causes
The disease may be due to atherosclerosis, aneurysm, trauma, tumor or foreign body damage to the wall and the formation of thrombus, slow occlusion of the aorta, there may be an opportunity to establish collateral circulation, usually only cause the lower extremity arterial hemorrhage.
Symptoms
The typical presentation is the so-called Leriche triad: intermittent claudication or rest pain in the lower extremities, impotence or difficulty in penile erection in male patients, and diminished or absent femoral arterial pulsation. In severe cases of lower limb ischemia, resting pain, tissue necrosis and ischemic neuropathy may occur.
Examination
1、Doppler ultrasound
It helps to identify aortoiliac artery lesions and often requires fasting.
2、Stage arterial pressure
Helps to determine the clinical diagnosis of peripheral vascular disease and the location of occlusive lesions.
3、CT angiography (CTA) and magnetic resonance angiography (MRA)
Can be used as the basis for determining the diagnosis, each has its own advantages and disadvantages, and the examination is selected according to the specific situation of the patient.
4、Arterial angiography
5、Other tests
(1) Endothelin-1 test Endothelin-1 (ET-1) is the only endothelin synthesized and secreted by the vascular endothelium, ET-1 has strong vasoconstrictive biological activity and stimulates the endothelial cells to release t-PA. In the distribution of the population, the plasma level of ET-1 in the elderly is higher than that in the population, which may be one of the factors that make the elderly prone to thrombosis.
(2) Increased prothrombin regulatory protein Thrombin regulatory protein or thrombomodulin is a single-chain anticoagulant glycoprotein that exists on the surface of endothelial cells as a receptor for thrombin, TM binds to thrombin on the surface of endothelial cells to form a complex, and this complex specifically converts protein C to activated protein C (APC). TM is one of the sensitive specific molecular markers reflecting endothelial cell damage, and increased TM on the surface of plasma or endothelial cells indicates hypercoagulability and thrombosis.
(3) Platelet examination, including platelet adhesion, increased aggregation; plasma platelet releases increased, especially in the α-granule specific protein β-thromboglobulin (β-TG) and platelet factor 4 (PF4) increased and platelet α-granule membrane protein GMP-140 increased, the plasma α-plasma dense granule releases 5-hydroxytryptophan increased while platelet concentration decreased; Increased TXB2, a metabolite of plasma TXA2, and/or decreased prostacyclinylation time product (6-keto-PGF1α); both in response to platelet activation.
Diagnosis.
The diagnosis is established in most cases by a careful history and physical examination, which may be combined with ultrasound, CTA and MRA, and, if necessary, angiography. It needs to be differentiated from neurogenic claudication, arthritis, and aortitis.
Treatment
1、Drug treatment
For claudication symptoms, antiplatelet drugs, cilostazol and prostaglandins can be used to improve the symptoms.
2、Surgical treatment
Aortoiliac artery endarterectomy, aortoiliac artery artificial blood vessel diversion, femoral artery artificial blood vessel diversion, axillary femoral artery artificial blood vessel diversion.
3、Vascular endoluminal treatment
With the continuous progress of interventional technology, endoluminal therapy has become the main trend in the treatment of abdominal aortic thrombosis syndrome.
Questions you may be concerned about
How to take care of abdominal aortic thrombosis syndrome?
Nursing care for abdominal aortic thrombosis syndrome mainly includes adjusting blood pressure, blood glucose, blood lipids within the normal range, exercising appropriately, and improving dietary habits.
1. Adjusting blood pressure, blood sugar and blood lipids within the normal range: patients with abdominal aortic thrombosis syndrome must adjust their blood pressure, blood sugar and blood lipids within the normal range, so as to protect the integrity of blood vessels and prevent the occurrence of atherosclerosis.
2. Appropriate exercise: For patients with abdominal aortic thrombosis syndrome, they should develop good living habits, carry out appropriate activities and exercise, and avoid exertion at the same time.
3. Improve dietary habits: patients with abdominal aortic thrombosis syndrome should have a diet low in salt, sugar and fat, and consume a moderate amount of coarse grains or foods rich in dietary fiber, such as beans, celery, bananas and so on.
If there is any discomfort, please go to the hospital in time to avoid delaying the condition.